Joint Committee on Finance, Public Expenditure and Reform
Correspondence Item No: 2015/1376(b)
Irish Heart Foundation
Pre-Budget Submission
Investing in children’s future
health
July 2015
2 Investing in Children’s Future Health
The Irish Heart Foundation’s asks for Budget 2016
1. Reduce consumption and gain revenue through a tax on sugar
sweetened drinks.
2. Establish a Children’s Future Health Fund using a portion of the
revenue generated by the tax to promote a healthier future for all
Irish children and particularly for disadvantaged children who are disproportionately
affected by obesity and food poverty.
The Irish Heart Foundation is calling on the Government to use Budget 2016 to make a strong commitment
to healthy childhoods. Obesity and food poverty impact on people’s diets and there is a clear relationship
between poor diet and disease. Ireland is experiencing high levels of both – 7% of children rising to 36% of
older people are obese and food poverty affects almost one in eight citizens. Unless obesity and food
poverty rates are reduced it is predicted that there will be a significant impact on quality of life, life
expectancy and healthcare costs in Ireland.
Our purpose in proposing a sugary drinks tax is both to reduce consumption of these high sugar products
and to provide funding for health and nutrition programmes specifically targeting children and young
people. A tax on sugar sweetened drinks (SSDs) is one of several measures needed in a strategy to address
obesity and food poverty.
Key messages
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Prevalence of obesity in Ireland has increased significantly in the last two decades.
One of the driving forces behind higher rates of obesity and ill-health in the worst off communities
is food poverty. In 2013, one in eight people were experiencing food poverty, an increase from one
in ten people in 2010.
SSDs are drinks with high levels of added sugar, including fizzy, sports and energy drinks.
SSDs are the most consumed beverage in Ireland. 21% of 1 year olds; 53% of 4 year olds; and at
least 75% of 5-18 year olds consume SSDs.
Consumption of SSDs may influence the development of obesity amongst children.
Only taxes achieving a 10-20% price increase will reduce consumption of SSDs.
In Mexico, a 1 peso tax increased price by 10%, led to a 6% reduction in consumption and
generated $1.3bn USD in tax.
In Ireland, it is estimated that an SSD tax increasing price by 20% would reduce consumption by
18% and would €44.5m.
It is estimated that a 20% SSD tax would reduce the number of obese adults in Ireland by 22,000.
A 20% SSD tax would lead to an increase in household spend of 67- 82 cent per week.
52% of the Irish public supports the introduction of an SSD tax.
3 RECOMMENDATION 1
Reduce consumption and gain revenue – a tax on sugar sweetened drinks
Introduce a tax on sugar sweetened drinks which increases price by at least 20%.
Generate approximately €50 million per year.
Use a portion of the collected revenue to fund a Children’s Future Health Fund.
Sugar sweetened drinks (SSDs) are drinks with high levels of added sugar, including fizzy, sports and energy
drinks. SSDs play a unique role in the obesity epidemic1 – they have no nutritional value and do not provide
a feeling of fullness. As a result, people usually consume SSDs in addition to the food they eat. SSDs are
inexpensive, readily available, high in calories, appeal to our taste for sweetness and are strongly associated
with weight gain. They are also heavily marketed, especially to children, often using celebrities and
sponsorship of sporting events.
The SSD tax is just one measure which is needed to reduce consumption, encourage healthier diets and to
influence the food industry to focus on selling and promoting more nutritious products. Policies which
would bolster the impact of the tax include: increasing availability of water in schools and public buildings;
introduction of a national healthy school food standard (including removal of all vending machines and junk
food from schools); a ban on marketing of SSDs targeted at children (under-18); clear and easy to
understand labelling showing just how much sugar is in each product; supports for those experiencing food
poverty; and subsidies to reduce the price of healthy foods.
Implementing the SSD tax
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Introduce a volumetric tax on all SSDs
Set tax at a rate to achieve at least a 20% price increase
SSDs are an easy-to-define category of products that are energy-dense and nutrient-poor but with close and
healthier substitutes. Water and milk are the healthiest drinks for children and adults – water is the best
thirst quencher, providing rehydration without calories, while milk is a rich source of calcium and protein.
Taxes on SSDs are shown to be most effective when applied to all types of SSDs because this makes it more
difficult for consumers to substitute similar products to avoid the price increase.2 Introducing an SSD tax by
volume is likely to be the simplest way to administer the measure. Research also indicates that a volumetric
tax would have a greater impact on health.3 Such a tax would increase proportionately to the volume of the
drink purchased, thereby discouraging consumers purchasing higher volumes, or switching to cheaper
brands to reduce the effect of the tax. In order to achieve public health goals, the level of taxation must be
set so as to affect behaviour and reduce consumption of SSDs.4 Economic studies consistently find that a
higher tax rate would be likely to have a greater impact on consumption.5 The widespread consumption of
SSDs in Ireland means that even small taxes will generate considerable revenue, but as indicated by
research6,7 only taxes of at least 10-20% will reduce consumption. The application of an SSD tax will not
impact on export trade, as goods for export will not be subject to the tax.
4 SSD taxes in France and Mexico
France, Finland, Hungary, Mexico and a number of US states have introduced a form of SSD tax and their
citizens are reaping the public health benefits.
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Mexico – 1 peso tax – 10% price increase – 6% reduction in consumption – $1.3bn USD8
On January 1, 2014, an SSD tax came into effect, with the aim of discouraging SSD consumption.
The amount of the tax was one peso ($.07 USD) per litre, which is roughly equivalent to a 10%
increase in price. Analysis following the first year of the tax revealed an average reduction of 6% in
the purchase of SSDs during 2014. This reduction increased over the course of the year to reach
12% by December 2014. The reduction in consumption was greatest among the lowest socioeconomic group – reducing SSD purchases by 9% on average during 2014 and achieving a
reduction of 17% by the end of the year. The tax generated $1.3 billion USD in 2014.
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France – 7c tax – 5% price increase – 3.3% reduction in consumption – €280m
In 2012 a volumetric tax of 7 cent per litre was applied to SSD and diet-SSD. Industry analysts9
found the tax led to a 5% increase in drink prices and a 3.3% reduction in consumption January –
May 2012. The tax generates approximately €280 million per year.10
Modelling the impact of an SSD tax in Ireland
The IHF contracted Landman Economics to model the potential impact – in terms of consumption and
revenue – of an SSD tax in Ireland at a range of tax rates.
In Ireland, it is estimated that an SSD tax increasing price by 20% would reduce consumption by 18% (107
million litres) and generate €44.5m.
Separately, estimates using the Household Budget Survey indicate that a 20% tax would lead to an increase
in household spending in the range of 67 – 82 cent per week / €35 – 43 per year.11
All calculations by Landman Economics, including low and high estimates are provided in Appendix 1.
Table 112: Tax applied to total soft drinks market (excluding bottled water) tax per litre €0.0508
€0.0716
€0.0915
€0.1436 €0.2554
tax per hectolitre €5.08
€ 7.16
€9.15
€ 14.36 € 25.54
Price increase as result of tax 10%
14.1%
20%
28.3% 50.3%
change in consumption (per cent) ‐9%
‐13%
‐18%
‐25% ‐45%
change in sales (million litres) ‐53.5
‐75.3
‐106.9
‐151.0 ‐268.6
total volume sold with tax in place (million litres) 540.4
518.6
487.0
442.9 325.3
Total annual tax yield (€m)
27.5
37.1
44.5
63.6 83.1
Note: Assumed own‐price elasticity of demand ‐0.9. Assumed pass‐through 90%. In the long term, an SSD tax will result in a reduction in obesity and diabetes cases, as well as healthcare
costs, as long as the tax is reinforced by a comprehensive policy to prevent and combat these chronic
diseases. Critics may say it is unfeasible to ring-fence some of the money raised for the Children’s Future
Health Fund. But there are Irish precedents which show how effective taxation can be at changing
5 behaviour and generating revenue. The plastic bag levy introduced in 2002 both reduced the use of plastic
bags and generated over €200 million for environmental projects over 10 years.13 The TV licence and car tax
are other examples of the ring-fencing of taxes for specific purposes. The IHF believes that the scale of the
human and financial cost of obesity and food poverty justifies a similar approach in this case.
The health justification for an SSD tax
The IHF is calling for an SSD tax given the link between SSD consumption and obesity and related
cardiovascular disease.
Prevalence of obesity in Ireland has increased significantly in the last two decades. Between 1990 and 2011,
obesity rose from 8% to 26% in men, and from 13% to 21% in women.14 Currently, 24% of adults (18-64
years) are obese. Amongst Irish children, rates of obesity accelerated from the 1970s and continued to
increase into the ‘Celtic Tiger’ period.15 Depending on the definition of obesity and the cut-off points used,
there has been a dramatic two-to-fourfold increase in obesity in Irish children aged 8–12 years since 1990.16
A growing body of research17 indicates that an increase in consumption of SSDs is associated with increases
in calories, weight gain, obesity and a variety of other negative health consequences and that the
consumption of SSDs may influence the development of obesity amongst children, adolescents and
adults18,19,20. There is convincing evidence from randomised control trials that reducing intake of SSDs
decreases risk of weight gain and obesity in children and young people. There is a dose-response
relationship between SSDs and weight gain – as SSD intake increases, weight gain also increases.21
Carbonated drinks are the most consumed beverage in Ireland.22 In 2010, almost three times more
carbonated drinks were consumed (83 litres per person) compared to the second most consumed beverage
(bottled water at 30 litres per person). SSDs are a major contributor to sugar in diets, especially in children
and young people23. 21% of 1 year olds and 53% of 4 year olds consume SSDs. At least 75% of 5-18 year olds
consume SSDs. 40% of adults regularly drink SSDs.
The team which undertook the SSD tax Health Impact Assessment24 for the Department of Health
concluded that a 20% tax would reduce the number of obese adults in Ireland by 22,000.25 Although not
modelled, it can be reasonably concluded that the tax would also impact on the number of obese children.
The World Health Organisation is developing new guidelines on sugar consumption, proposing that for
good health sugars should make up less than 5% of total energy intake per day for adults and children.
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5% of total energy intake is approximately: 7 teaspoons of sugar per day for an adult of normal
Body Mass Index (BMI), or 4 ½ teaspoons of sugar per day for a 5 year old child.
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A 500 ml bottle of cola can contain up to 12.5 teaspoons of sugar. A 500ml energy drink can
contain up to 21.5 teaspoons.26
Impact of an SSD tax on people with low incomes
There is a pronounced social gradient in obesity, apparent in Irish children as young as three years of age.27
Obesity disproportionately affects disadvantaged groups for many reasons. Because of their lower incomes,
poorer people tend to rely on the foods which are cheaper and more energy-dense. Unhealthy foods with
added sugar or fats often provide the most energy for the lowest cost. There is also growing evidence that
people with lower incomes tend to live further away from shops selling healthy food at affordable prices. 28
6 Progressive health gains are expected from a tax on SSDs for people on low incomes because they tend to
have a higher incidence of most diet related diseases, particularly cardiovascular disease. The health effects
of SSD consumption, including risk of obesity and heart disease, disproportionately impact economically
disadvantaged groups. Coronary heart disease is 2.5 times more prevalent and stroke 2.2 times more
prevalent in the most deprived areas compared to the least deprived areas. 29 Assuming similar dietary
changes in the whole population, the reduction in disease incidence following a tax increase would be
greater among lower income groups.
While an SSD tax would absorb a greater proportion of the food budget of a low income family, this is only
likely to be a small amount of their overall food budget. Irish households currently spend somewhere
between €3.36-€4.15 per week, or €175-€215 per year on SSDs. A tax increasing price by 20% would lead to
an increase in household spend of 67- 82 cent per week / €35- 43 per year.30
The Irish Heart Foundation wants to make it more feasible for people with low incomes to purchase healthy
foods. Combining taxes with subsidies can produce even greater progressive health benefits, particularly if
the subsidies are targeted at those most affected by the tax. The Children’s Future Health Fund will prioritise
supports for children and families with low incomes.
Public support
Following years of austerity, the public are understandably weary of taxation, yet there is a majority in favour
of a tax on SSDs. An Ipsos MRBI poll carried out for the Irish Heart Foundation in May 201431 shows that the
public expects the Government to exercise its role as a protector of public health. 52% of the Irish public
support the introduction of an SSD tax. Almost 90% agreed that SSDs contribute to obesity among children
and agreed that Irish children and young people consume too many SSDs.
7 Arguments from the food industry
“It won’t work.”
Lobbyists from the food industry seem reluctant to accept an SSD tax because of concerns that the tax will
affect consumption, sales and profits. Therefore there appears to be unanimous agreement between those
in favour of an SSD tax on health grounds and the food industry that the tax will reduce consumption.
Leading multinational companies have the majority share of all beverage markets (carbonates, nectars,
squashes/syrups, sports drinks, energy drinks, still drinks) in Ireland.32 Multinational processed food
companies exist to make money for their shareholders. Getting ‘stomach share’, or driving more ounces into
the body more often, is their priority. They seek to sell as much of their products as possible and cannot at
the same time help consumers to reduce consumption. The industry can undermine people’s ability to resist
over-consuming SSDs by spending millions to advertise them, especially to children. Other industry
strategies to increase consumption include lowering the price as the size increases and making them widely
SSDs available in schools, sports venues and cinemas.
Companies claim to be part of the solution to obesity and poor nutrition by funding community and school
initiatives for obesity prevention. If the industry was serious about being part of the solution, it would grant
these funds anonymously, rather than using donations as another marketing opportunity.
“It is regressive.”
When the industry makes an argument about the possible regressive nature of an SSD tax, we might ask why
the very small number of highly profitable multinational processed food companies – which control the
majority of food we all consume – don’t consider reducing the prices of their healthier products, instead of
seeking to maintain the profits they receive from SSDs.
As discussed above, the health gains of the SSD tax will be progressive, improving the health of low income
groups more significantly. In addition, it is proposed that the Children’s Future Health Fund will prioritise
supports for children and families with low incomes.
“It will cost jobs.”
When discussing fiscal measures designed to reduce consumption of a certain product industry
representatives tend to cite the potential job losses in the particular sector concerned, without accounting
for new jobs in other sectors which will develop following the policy change. This industry argument
assumes that money currently spent on SSDs would disappear, rather than be spent in other areas of the
economy. Indeed, those beverage companies with diversified ranges providing alternatives to SSDs could
have an increase in sales of those alternative brands following the introduction of an SSD tax. The industry
also ignores the economic activity associated with the tax revenue generated. Research on the Irish market33
indicates that the employment effects of a tax on SSDs and a subsidy on fruit and vegetables are likely to be
neutral at worst and maybe even positive, because the fruit and vegetable sector is more labour intensive
than the beverage sector.
8 RECOMMENDATION 2
Invest in children’s health through a Children’s Future Health Fund.
Use a portion of the SSD tax revenue to establish a Children’s Future Health Fund to promote a
healthier future for all Irish children and particularly those from disadvantaged areas who are
disproportionately affected by obesity and food poverty.
The Irish Heart Foundation believes that by using a portion of the revenue from an SSD tax, to finance a
Children’s Future Health Fund, Budget 2016 could be used to effect far reaching additional benefits by
supporting policies to tackle obesity and food poverty among children.
Parents want their children to be healthy. Of course they do. But there are many challenges in the way. The
environment that children live in often promotes ill-health. Marketing for SSDs, sweets and take-away foods
is everywhere. Big sporting events promote alcohol, making drinking alcohol seem a normal part of life. TV,
video games and the internet can make going outside to play seem boring. One of the driving forces behind
higher rates of obesity and ill-health in the worst off communities is food poverty. For people living in these
communities, the struggle is for survival and they often have no option but to buy cheap processed and
energy dense foods. The pursuit of a healthy and nutritional diet for their children is beyond their buying
power.
Obesity
Depending on the definition of obesity and the cut-off points used, there has been a dramatic two-tofourfold increase in obesity in Irish children aged 8–12 years since 1990.
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Differences in health in children from richer and poorer areas are obvious from as early as three
years of age.35
The Growing Up in Ireland study shows that social inequalities increase the risk of overweight and
obesity from an early age. At 9 years of age, children from disadvantaged areas are much more
likely to be obese.
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34
36
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Only 20% of children say they eat fruit and vegetables more than once a day.
children exercise four, or more times a week.
Just over half of
38
Childhood obesity is associated with increased cardiovascular risk.39 In the short term, obese children may
experience health problems including type 2 diabetes and cardiovascular problems. Long-term, obese
children are more likely to be obese in adulthood, with related cardiovascular risk factors.40 Research
indicates that some children are already developing signs of coronary heart disease, high blood pressure,
high cholesterol, Type 2 diabetes. Eight per cent of the children participating in the Cork Children’s Lifestyle
Study were classified as having high blood pressure. Twice as many overweight/obese children had high
blood pressure when compared to normal weight children.41
9 Food poverty
Food poverty is primarily the result of low incomes and is the inability to have a nutritious diet due to
affordability or accessibility. In 2013, 13.2% (one in eight) of the population were experiencing food
poverty42, an increase from one in ten people in 2010.43 Low-income households consume less nutritionally
balanced diets and suffer from higher rates of diet-related ill-health such as diabetes, heart disease, obesity
and cancer from a younger age.
Research in Ireland has found that low-income households in Ireland are most at risk of inadequate diet and
its negative effects on health and well-being.44 People in low-income households know the foods which are
healthy, but are restricted by financial and physical constraints in following such a diet.45 Families with
children in Ireland are three times as likely as those without children to be affected by food poverty.46
Families with older children would have to spend 59% of their Child Income Support on food alone in order
to meet the recommended dietary requirements for a teenage child.47
This won’t be resolved by market forces. Research shows that calories from healthy foods like fruit,
vegetables and lean meat are up to 10 times more expensive than from foods high in fat, sugar and salt.48
Given the massive ongoing investment by the multinational processed food industry in methods to make
highly profitable, unhealthy foods cheaper, State intervention is urgently needed.
Children’s Future Health Fund
To tackle obesity
School food
Remove all junk food from schools and extend existing nutritious food provision
models which are already operating nationally. Extend free school meals
programmes. Develop healthy living modules on primary and secondary curricula.
Planning regulation
‘no fry zones’
Introduce no fry zones within 1 km of schools. At present 75% of Irish schools have
at least one and 30% have at least five fast food outlets within 1km.
Subsidies for healthy
food
Introduce fruit and vegetable subsidies, targeted at disadvantaged communities
where obesity levels are almost three times higher than in better off
communities.
Food labelling
Stop protecting the international processed food industry from having to inform
consumers about products with high fat, sugar and salt content through front-ofpack red, amber and green traffic light labelling.
Controlling food and
drink marketing to
children
End advertising of products high in fat, sugar and salt on TV before 9pm.
Regulate other media channels, such as the Internet, on computer games, via text
messaging etc.
Physical activity
Ensure that children get 60 minutes of physical activity a day. Review school PE
provision as Ireland is third worst at primary level and seventh worst at
secondary level in the EU for PE provision.
To tackle food poverty
Family Food Initiatives
Develop Family Food Initiatives (FFIs) to support children and families
experiencing food poverty to have access to healthy food and to develop cooking
and food growing skills. 30 FFIs could be established at a cost €2.475m over a 5
year programme 2016-2020.
10 Conclusion
The Irish Heart Foundation recognises that in introducing an SSD tax, the Government will face opposition
from the beverage industry and from the wider food industry citing a perceived impact of the tax on their
profit levels. The State has a duty of care to intervene with measures that protect its citizens. The choice that
has to be made is not public health over the food industry – just a balance between the two that puts
children’s needs first.
The introduction of an SSD tax would give a clear indication to industry that the government’s approach to
nutritious food is changing and incentivise companies to provide healthier options. While the SSD tax on its
own will have a small but significant impact on obesity, the impact could be majorly bolstered by the
creation of the Children’s Future Health Fund to support policies to tackle obesity and food poverty among
children and their families.
For further information contact:
Chris Macey, Head of Advocacy, [email protected]
Cliona Loughnane, Policy and Research Manager, [email protected]
Irish Heart Foundation, 50 Ringsend Road, Dublin 4. (01) 6685001
11 1
Brownell, K.D. and Frieden, M.D. (2009) ‘Ounces of Prevention – the public policy case for taxes on sugared beverages’. New England Journal of Medicine, 360 (18), 1805‐1808. 2
Finkelstein et al. (2010) ‘Impact of targeted beverage taxes on higher‐ and lower‐income households’. Archives of Internal Medicine, 13 (27), 2028‐2034. 3
Sharma, A. et al. (2014) ‘The effects of taxing sugar‐sweetened beverages across different income groups’. Health Economics. 4
Brownell, K.D. and Frieden, M.D. (2009) ‘Ounces of Prevention – the public policy case for taxes on sugared beverages’. New England Journal of Medicine, 360 (18), 1805‐1808. 5
Andreyeva,T. et al. (2011) ‘Estimating the potential of taxes on sugar sweetened beverages to reduce consumption and generate revenue’. Prev. Med. 6
Mytton et al. (2012) ‘Taxing unhealthy food and drinks to improve health’. BMJ. 7
Ng et al. (2012) ‘Patterns and trends of beverage consumption among children and adults in Great Britain, 1986‐2009’. British Journal of Nutrition, 108 (3), 536‐551. 8
Mexican National Institute of Public Health Press Release, 16th June 2015, ‘Mexico’s National Institute of Public Health study indicates the federal sugar‐sweetened beverage tax is successfully reducing purchases in Mexican households’. 9
See page 20, National Heart Forum (2012) ‘What is the role of health‐related food duties? A report of the National Heart th
Forum meeting, 29 June 2012. http://www.worldobesity.org/site_media/uploads/UKHF_duties.pdf 10
WHO Europe (2015) Using pricing policies to promote healthier diets. Denmark: WHO Europe. 11
Presentation by Dr Micheál Collins, 23rd June 2014 to Irish Heart Foundation Seminar, ‘A SSD Tax: Revenue & Income Distribution implications’. This estimate does not account for the reduction in consumption which the tax is intended to achieve. 12
Calculations conducted by Landman Economics (June 2015) for the Irish Heart Foundation. 13
Parliamentary Question to the Minister for Environment, Community and Local Government, 16th July 2013 – Tax Yield. 14
Irish Universities Nutrition Alliance (IUNA) (2011). National Adult Nutrition Survey. 15
Perry, I., Whelton, H., Harrington, J. and Cousins, B. (2009) ‘The heights and weights of Irish children from the post‐war era to the Celtic tiger’. Journal of Epidemiology and Community Health, 63(3), 262‐264. 16
O'Neill JL, McCarthy SN, Burke SJ et al (2007). Prevalence of overweight and obesity in Irish schoolchildren, using four different definitions. Eur J Clin Nutr:61(6);743‐51. 17
For e.g., Chaloupka, FJ, Powell, LM, Chriqui, JE. ( 2009) Sugar‐sweetened Beverage Taxes and Public Health. A research brief. Robert Wood Foundation. wwwrwif.org 18
de Ruyter et al. (2012) ‘A trial of sugar‐free or sugar‐sweetened drinks and body weight in children’. New England Journal of Medicine. DOI: 10.1056/NEJMoa1203034. 19
Ebbeling et al. (2012) ‘A randomized trial of sugar‐sweetened drinks and adolescent body weight’. New England Journal of Medicince. DOI: 10.1056/NEJMoa1203388 20
Qi et al. (2012) ‘Sugar‐sweetened drinks and genetic risk of obesity’. New England Journal of Medicine. DOI: 10.1056/NEJMoa1203039 21
For a discussion of the evidence, see: Hu, F.B. (2013) ‘Pro v Con debate: role of sugar sweetened beverages in obesity. Resolved: there is sufficient scientific evidence that decreasing sugar‐ sweetened beverage consumption will reduce the prevalence of obesity and obesity‐related diseases’. Obesity Reviews, 14, 606‐619. 22
Consumption details provided in Institute of Public Health (2012) Proposed Sugar Sweetened Drinks Tax: Health Impact Assessment (HIA) Technical Report. http://www.publichealth.ie/document/iph‐report/proposed‐sugar‐sweetened‐drinks‐
tax‐health‐impact‐assessment‐technical‐report 23
For example a 2013 survey found that 45 per cent of children (10‐17yrs) drink soft drinks at least once a day or more. safefood / Millward Brown Lansdowne (October 2013) ‘Safefood Benchmark survey of 900 people on the island of Ireland’. 24
Institute of Public Health (2012) Proposed Sugar Sweetened Drinks Tax: Health Impact Assessment (HIA) Report. Dublin: Institute of Public Health. 25
Estimated by Dr Adam Briggs and presented at Irish Heart Foundation Seminar ‘20% tax on Sugar Sweetened Drinks’, Monday 23rd June 2014, The Gibson Hotel, Dublin 1. 26
Irish Nutrition and Dietetic Institute (2014) ‘Factsheet – Understanding sugars and how they affect your health.’ https://www.indi.ie/fact‐sheets/fact‐sheets‐on‐food/708‐this‐fact‐sheet‐will‐help‐you‐to‐understand‐how‐sugar‐might‐
affect‐your‐health‐and‐wellbeing.html 27
Growing Up in Ireland (September 2013) Development from birth to three years. http://www.growingup.ie/fileadmin/user_upload/documents/Second_Infant_Cohort_Reports/ES_Development_from_Birth 28
For example, see Layte, R. and McCrory, C. (2011) ‘Growing Up in Ireland – overweight and obesity among 9 year olds, report 2’. Dublin: Department of Children and Youth Affairs. http://www.growingup.ie/fileadmin/user_upload/documents/Second_Child_Cohort_Reports/Growing_Up_in_Ireland_‐
_Overweight_and_Obesity_Among_9‐Year‐Olds.pdf 29
Balanda, K. et al. (2010). Making Chronic Conditions Count: Hypertension, Stroke, Coronary Heart Disease and Diabetes. Dublin: Institute of Public Health in Ireland. 30
Presentation by Dr Michael Collins, 23rd June 2014 to Irish Heart Foundation Seminar, ‘A SSD Tax: Revenue & Income Distribution implications’. 12 31
Ipsos MRBI nationwide poll of 1,008 adults for the Irish Heart Foundation, May 2014. See http://www.irishheart.ie/iopen24/irish‐public‐supports‐sugary‐drink‐obesity‐rate‐n‐467.html 32
Almost 90% of the carbonates market is controlled by leading companies – Coca‐Cola 54.4%, Pepsi‐Co 20.1%, Britvic 9.5% and Gleeson Group 5.3%. Unbranded products have only a very small market share. See: Institute of Public Health (2012) Proposed Sugar Sweetened Drinks Tax: Health Impact Assessment (HIA) Technical Report. http://www.publichealth.ie/document/iph‐report/proposed‐sugar‐sweetened‐drinks‐tax‐health‐impact‐assessment‐
technical‐report 33
Professor David Madden, School of Economics, University College Dublin, Presentation and ‘Food, Fat and Fiscal th
Measures’ Irish Heart Foundation Seminar, 20 March 2013. Presentation available at: http://www.irishheart.ie/media/pub/foot_fat_and_fiscal_measures__some_observations__david_madden.pdf 34
O'Neill JL, McCarthy SN, Burke SJ et al (2007). Prevalence of overweight and obesity in Irish schoolchildren, using four different definitions. Eur J Clin Nutr:61(6);743‐51. 35
Growing Up in Ireland (September 2013) Development from birth to three years. http://www.growingup.ie/fileadmin/user_upload/documents/Second_Infant_Cohort_Reports/ES_Development_from_Birth 36
Layte, R. and McCrory, C. (2011) Growing up in Ireland ‐ Overweight and obesity among 9‐year olds. Dublin: The Stationary Office. 37
Self‐reported by children & young people surveyed. Kelly, C., Gavin, A., Molcho, M. & Nic Gabhainn, S. (2012). The Irish Health Behaviours in School‐aged Children study (HBSC) study 2010. Dublin: Department of Health. 38
Kelly, C., Gavin, A., Molcho, M. & Nic Gabhainn, S. (2012). The Irish Health Behaviours in School‐aged Children (HBSC) study 2010. Dublin: Department of Health. 39
Juonala, M., Magnussen, C., Berenson, G., Venn, A., Burns, T., Sabin, M., Srinivasan, S., Daniels, S., Davis, P., Chen, W., Sun, C., Cheung, C., Viikari, J., Dwyer, T. and Raitakari, O. (2011) ‘Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors’. New England Journal of Medicine, 365 (20), 1876‐1885. 40
Department of Health and Children (2005) The Report of the National Taskforce on Obesity and WHO (2014) Report of the Ad hoc Working Group on Science and Evidence for Ending Childhood Obesity: 18‐20 June 2014, Geneva, Switzerland. http://apps.who.int/iris/bitstream/10665/133545/1/9789241507653_eng.pdf?ua=1 41
Safefood news (2014) ‘Cork Children’s Lifestyle Survey’. Available at: http://www.safefood.eu/Professional/Nutrition/Nutrition‐News/March‐2014/Cork‐Children%E2%80%99s‐Lifestyle‐
Study.aspx 42
Department of Social Protection (2014) Social Inclusion Monitor 2013. Dublin: Department of Social Protection. 43
Carney, C. and Maître, B. (2012) Constructing a Food Poverty Indicator for Ireland Department of Social Protection.Dublin: Department of Social Protection. http://www.welfare.ie/en/downloads/dspfoodpovertypaper.pdf 44
Friel, S. and Conlon, C. (2004) Food poverty and policy. Dublin: Combat Poverty Agency, Cross Care and St. Vincent de Paul and Harrington, J., Fitzgerald, P., Layte, R., Lutomski, J., Molcho, M. and Perry, I. (2011) ‘Sociodemographic, health and lifestyle predictors of poor diets’. Public Health Nutrition, doi:10.1017/S136898001100098X. 45
P. 11, Friel, S. and Conlon, C. (2004) Food poverty and policy. Dublin: Combat Poverty Agency, Cross Care and St. Vincent de Paul. 46
Carney, C. and Maître, B. (2012) Constructing a Food Poverty Indicator for Ireland Department of Social Protection.Dublin: Department of Social Protection. 47
Vincentian Partnership for Social Justice (2012) The Cost of a Child. 48
In the course of work to update healthy food guidance and the ‘food pyramid’, the Food Safety Authority of Ireland (FSAI) found that calories from foods high in fat, sugar and salt are up to ten times cheaper than from nutritious foods such as fruit, vegetables and lean meats. The FSAI’s research shows the cost of healthy eating compromises the ability of low income households to achieve healthy dietary goals and that healthy eating is more expensive for households with children, particularly those with teenagers. Food Safety Authority of Ireland (2011) Scientific Recommendations for Healthy Eating in Ireland. Dublin: FSAI. 13